Archives

January 14, 2019 by Sandra Steingard, MD

Open Dialogue: Does the Current Research Data Support Further Investment?

Psychiatric Services, a leading US journal, has published two important papers on Open Dialogue. Freeman and colleagues did an extensive literature review and analysis of currently available research. Their paper is accompanied by a commentary by Kim Mueser, PhD, Director of the Boston University Center for Psychiatric Rehabilitation and one of the world’s experts in his field.

Freeman and colleagues begin their paper with a detailed explanation of the criteria for inclusion into their investigation. They identified 23 studies for review. Papers selected were published in English and evaluated Open Dialogue effectiveness using either case study, qualitative, quantitative, or mixed methods. Studies were conducted in Finland, Norway, Sweden, and the US.

As the authors point out, most of the available research comes from the Western Lapland group that developed Open Dialogue (OD). This poses a fundamental source of weakness in the evidence base. Their studies had small sample sizes, there was no control group, and the ratings were not blinded. In addition, there were not consistent methods for either defining or evaluating OD.

Many of us learned of Open Dialogue because of their reported excellent outcomes for individuals who experienced a first episode of psychosis. We are eager to see if these results can be replicated elsewhere. But there are other important questions.

Pathways to Enhance Well-Being and the backstory

(Lauren Spiro) – This week we e-release this new free booklet, Pathways to Enhance Well-Being. The evolving story provides an example of how we can follow the life pulse that moves through us – in this case – it moved through the three co-authors and manifests something new that we hope will be helpful for many people.

My co-creators and I, and seemingly the stars too, were aligned on this project. For each of us, our life story has in large part been about finding pathways to enhance our own well-being and to assist others in doing the same.

We came together with heart-based and soul-based intention to share some of the practices that have transformed our lives, opening our bodies and minds which allowed joy and passion to flow through us. We don’t write about our transformative process in the booklet but make no mistake – this is the energy that flowed through us and we hope that you, the reader, can feel in yourself as you expand or deepen your use of body/mind/spirit practices.

What I’ve learned so far: adventures on the road to healing

Friend of the Foundation, Stephanie Long, offers her story in solidarity and encouragement to others with lived experience of the mental health care system. This is episode 2 of the series

After high school I got a job at Macy’s. I just wanted something super easy because inside I was fighting this terrible mental battle and didn’t believe I could handle a job that made me think. I worked there for about four years but realized I didn’t want a minimum wage job for the rest of my life, so I needed to figure out what to do next. I thought getting into the medical field would be a great career, not knowing what I wanted to do in the field, so I applied as a receptionist at a doctor’s office to get my foot in the door. After working there for about a year, I hated it and realized I didn’t want to go to school for something in the healthcare field. Also, at this point I was feeling so out of control in my mind. I was fighting with friends and family and cutting them out of my life, so they didn’t have to see me self-destruct. I felt it was time that I should go see a doctor and figure out what was going on in my head.

What I’ve learned so far: adventures on the road to healing

Friend of the Foundation, Stephanie Long, offers her story in solidarity and encouragement to others with lived experience of the mental health care system

My story begins when I was a teenager. I knew something wasn’t right with me because I would be extremely happy one day – euphoric like, then the next day I’d be extremely depressed and wouldn’t want to get out of bed and face people. I would often ask my mom why I’m like this and she’d brush it off that I was a moody teenager. I knew I was moody with my hormones being all over the place, but I felt this went beyond normal teenage angst.

As I got older, my anger, depression, and anxiety was getting worse and I started self medicating with alcohol because this would take my pain away for a while. My mom wouldn’t listen to me, that I wanted to see a doctor about my problems, because we don’t talk about mental health in my family. Ironically enough, it runs on both sides of my family, yet it’s a forbidden topic. I tried to talk to my grandma about it but she said I was exaggerating my issues.

By the time I was 16, and I could hardly stand to be in my own skin, and my mom and I were fighting daily- making it a very toxic situation, so I left home.

Peer Support for Children & Young People who Hear Voices

Hearing voices is a common experience, yet it’s one that’s seldom talked about.

Although the latest stats have shown that up to 12% of young people hear things, see things or sense things that other people don’t, they tell us that the misinformation, fear and stigma surrounding these experiences makes it incredibly difficult for them to share what’s going on and to seek support if they’re struggling.

That’s where we aim to help.

About Voice Collective
We launched the Voice Collective service in 2009, with the aim of building capacity within existing programs to enhance their support for children and young people who hear voices, see visions or have other unusual sensory experiences, paranoia or unusual beliefs or multiplicity.

Although many children and young people who have these experiences aren’t distressed by them, others describe a combination of positive, negative and neutral experiences. Some young people can find their voices or visions overwhelming, confusing, frightening or upsetting, and some struggle with feelings of powerlessness, worthlessness or hopelessness. They may be self-harming, feeling suicidal or have attempted to end their lives.

We support children and young people in distress by normalising what they’re going through, reducing isolation and stigma and increasing coping skills, self-esteem and their capacity to live lives that they’ll love.

When Rain Comes, Words Are Unnecessary: Our Search for a Better Way

Living in New Mexico means hoping for rain. The state is in drought, with most areas officially in either “extreme” or “exceptional” drought. The soil is full of life waiting for a chance to express itself, but the rare rain forecasts usually promise only “scattered showers nearby,” with the outcome being either clear blue skies or the sight of rain falling elsewhere. New Mexico is also one of the poorest states in the U.S., with more than one in five New Mexicans, and one in four children, living in poverty. We are second in the nation for the prevalence of youth living without connection to work, school, or family. New Mexico ranks high (#7) for people living with serious mental and emotional challenges.

Fort Collins Research Collaborative Recruiting for Second Test Group of Novel Program

The Fort Collins-based Learning and Self-development Collaborative grant project is midway through supporting its first group of young adults experiencing mood-related distress. It is also actively recruiting for the second group, scheduled to start in late August.

Nearly three-quarters of the young adults in the first group have prior mood disorder diagnoses and have tried psychiatric medications like antidepressants. However, the ineffectiveness and intolerable side effects of the drugs had left them searching for an alternative way forward when they decided to enroll in the Learning and Self-development Collaborative. These young adults are currently medication-free and their outcomes on mood distress, social connectedness, empowerment, and quality of life at six months will be compared to other young adults receiving usual care and daily psychiatric medications in the community.

An initial focus group with participants revealed a number of themes related to young adults’ past experiences with seeking help. Participants discussed feeling frustrated by one-size-fits-all solutions, such as drugs and mindfulness techniques, and invalidated by counselors who failed to connect with their experiences. Lack of information about prescribed drugs was frequently brought up by participants who also shared various stories of “chemical imbalance” and drugs “re-training the brain to relax” told to them by doctors and therapists.

Findings from pre-program focus groups are being used to help inform the content and delivery of educational material in the Learning and Self-development Collaborative.

A Request for 2 Minutes of Help

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There have been almost 900,000 views of Julia Rucklidge’s 2015 TEDx talk on nutrition and mental health, with many complimentary viewer comments.

Last week, however, the TED organization has inexplicably “flagged” the video with the following comment:

“NOTE FROM TED: We’ve flagged this talk, which was filmed at a TEDx event, because it appears to fall outside TEDx’s curatorial guidelines. There is limited evidence to support the claims made by this speaker.”

Julia has attempted to educate TED staff regarding the fact that over 35 peer-reviewed publications could hardly be described as “limited evidence,” and that her interpretations do not go beyond the data. But so far they are not interested in her evidence.

The whole thing seems so strange: isn’t TED supposed to be all about innovation? But clearly, some lobbyist has convinced them that a non-pharmaceutical treatment should not be respected.

I am asking you to help make this video go viral. That seems to be the only response we can make to such an inappropriate move on TED’s part.

Dr. Bonnie Kaplan, PhD is the fund advisor of the Nutrition & Mental Health Research Fund and a member of the new International Society for Nutritional Psychiatry Research (ISNPR). For many years, she studied developmental disorders in children, especially ADHD and reading disabilities (dyslexia). Dr. Kaplan was part of a team from University of Calgary and University of British Columbia which helped in the search for genes that predispose children to dyslexia. Also, with her students, she investigated the characteristics of adults with ADHD. Such work led her to further investigations of the role of nutrition. Another interest has been the mood symptoms that accompany ADHD and learning difficulties, and the role of micronutrient treatment of mood, aggression and explosive rage. This progression of topics has resulted in a research program focused on the role of nutrition in brain development and in brain function, especially the use of broad spectrum micronutrient treatment for mental disorders.

So What’s This About Another Webinar Series on Psychiatric Drug Withdrawal?

Some people are asking me, “Why another series of webinars on withdrawing from psychiatric drugs?” That’s a reasonable question given that our first series, Withdrawal from Psychiatric Drugs, covered a lot of territory. We presented general information as well as more specific subjects like wellness, personal experiences, research findings, and the evidence base for drug withdrawal.

But this subject is a complex one, and our first course was just our start in exploring this topic. With this second course we are focusing on the challenges that drug withdrawal presents to prescribers.

As many have noted, prescribers may have extensive experience getting patients on psychiatric medications and then managing their drug use, but little or no experience helping patients taper off the drugs. As some have quipped, prescribers have learned to fly the plane but not land it.

Crisis Now: Transforming Services is Within Our Reach

The following is a report from the National Action Alliance for Suicide Prevention Crisis Services Task Force from 2016, which focuses on transforming crisis response services to include recognition and response to trauma, a robust role for peer support, and a reorientation to recovery. This report, which we currently are finding very valuable in our on-going system transformation efforts in Connecticut, is a testament to the fact that even acute services, and even those services addressing persons in extreme distress, can be made strength-based, person-centered, culturally responsive (in including natural and community supports), and recovery-oriented.